Breast Revision in Baltimore, MD

Breast augmentation surgery continues to be the most popular cosmetic procedure in the U.S. While the majority of women are pleased with their augmentation results, some will decide to have the implants removed or replaced. Owing Mills plastic surgeon, Dr. Janet Woodyard has considerable experience in breast revision surgery and works with women to correct, remove or replace an existing implant. This decision is made because the implant is either in the wrong position or no longer aesthetically desirable. Replacement of older implants is also a consideration. Surgery for revision of prior breast lift, reduction or reconstruction also sometimes becomes necessary. Each breast revision procedure is  somewhat unique. The procedure(s) needed vary by circumstances and careful planning by an experienced surgeon is required.  This starts at the initial consultation.

Breast revision surgery resolves cosmetic issues following a prior cosmetic or reconstructive breast procedure, most frequently (but not exclusively) involving breast implants. The surgery focuses on removal, replacement, or making a switch from saline to silicone-based implants. Listed below are the most common cases where a patient may be a candidate for this treatment.

Individuals who wish to undergo breast augmentation do so to increase breast size primarily for aesthetics. However, after breast augmentation, some women may be dissatisfied with their results and opt to revert back to their normal breast size. Others may want to remove their implants because of health concerns or other personal reasons. Breast revision surgery is a process where the implant is removed and the skin over the breast is tightened to make sure the breast sits in a natural position and looks normal. This choice may arise as some women grow older.

Despite the guarantee that implants are safe and leakages are rare, there are cases when a shell breaks down. If it is filled with saline, the solution will be absorbed by the body, and there will be a noticeable deflation of the breast. In the case of silicone implant rupture, the size of the breast may not change and detection of a rupture becomes more difficult. It can sometimes be determined by physical exam by an experienced plastic surgeon and in some cases may require an MRI.

Scar tissue around an implant can increase over time and tighten, thereby causing a capsular contracture. This can cause the implant to appear smaller, feel firmer, become displaced and/or become uncomfortable. This is corrected by capsulotomy, to open up the tight capsule or capsulectomy, to remove it and replace the implant.

Visible rippling of the implant, while not a complication of the original surgery, may occur during the aging process and may require a breast lift(mastopexy) or larger implant for correction. This problem is more common in thin patients and with saline implants.

During the aging process of the augmented breast, a woman's breast tissue may drop more than the implant. This creates a "double bubble" appearance to the breast whereby the implant is situated higher than the nipple and natural breast tissue. Correction is by surgery to lift the breast and/or replace or reposition the implant.

Breast implants vary in size, texture, shape and base diameter. According to their personal preferences, some patients may be unhappy with how the breast looks and may consider a revision surgery to improve the appearance. They may desire a different size or implant shape. Some patients also later realize that they’d rather have silicone instead of saline. All preferences will be considered to modify the augmented breast.

Revision surgery is tailored to the cosmetic issues that need to be addressed. This may include implant replacement, scar tissue removal or alteration, or a lift if sagging is present. There are instances where an internal tissue matrix is required to support the repositioned implant if the natural tissues are thin or weakened. Ultimately, the corrective procedure is aimed at fixing the issues causing the patient's concern.

Breast revision surgery can sometimes performed under I.V. sedation and at other times under general anesthesia, depending on the nature and extent of the procedure being performed. The patient is usually sent home after treatment and seen in the office within a weeks time. Light activities can usually be resumed within a few days and full recovery is expected in 4 weeks with some settling of the implants over a few months time.